Orthopedic Wizard Takes on Complex Cases

The patient had been struck by a car and dragged 20 feet. His ribs were broken and his pelvis crushed, both in the front and the back. He could have faced months of painful recuperation while his bones healed, and the possibility of never walking normally again. Fortunately for him, his injuries were repaired by Cornelis Elmes, M.D., a NorthBay Healthcare orthopedic surgeon skilled in the latest trauma surgery techniques.

Before coming to NorthBay five years ago, Dr. Elmes had worked at Level I and Level II trauma centers in New York, Florida and California. It was not unusual for him to put in 100-hour-plus weeks, performing surgeries in difficult and traumatic cases. “I probably was doing at least one pelvic fracture repair a week, which can be particularly complex and challenging.”

While at those facilities he was also trained in several surgical innovations, including the use of special locking plates and nails, and the use of biologic agents. He brings his years of experience to NorthBay’s surgical suites, which are equipped with the latest in surgical equipment, such as a Stealth Navigator for computer-assisted surgery, and an O-arm Surgical Imaging System, which allows the surgeon to more accurately navigate to the exact point of injury. With these tools, he can fix large fractures using screws inserted through very small incisions, all in less time and with greater precision and accuracy.

“It’s amazing technology,” he says. “These surgical advances use less invasive techniques, which help reduce post-operative pain, the risk of infection and other complications.

“Locking plates and nails have also proven to be a revolutionary development in orthopedic surgery,” Dr. Elmes says. “They help us to treat the toughest of fractures, such as those that occur near joints or in the elderly, who have weak and fragile bones.”

With these devices, screws actually lock into the plate, making the construction much more rigid and strong. Before, “there was some degree of motion between the screw and plate,” he explains. “We also now have implants specifically designed for every major bone in the body, which helps complicated surgeries go more quickly and smoothly.”

Tremendous advances have also been made in the use of biological agents and bone plasters. “When these agents—bone graft substitutes, bone plasters and proteins—are added at the time of surgery, they can stimulate bone healing and growth, with improved outcomes for patients.”

When the bone plaster is injected into the fracture, he explains, it quickly hardens like cement, reaching strengths of up to 10 times that of normal bone. This allows people to walk weeks, if not months, earlier than previously possible, he says.

“The cutting-edge surgical equipment we have here at NorthBay would typically be found in a Level I or Level II trauma center, not usually in smaller community hospitals,” he adds.

Dr. Elmes’ surgical expertise and three patients who benefited from it—including the one who suffered a crushed pelvis—will be featured in a special PBS documentary. Called “Breakthroughs,” the documentary is expected to air in early 2014.

Dr. Elmes, a hospitalist in ortho-pedic surgery, can be reached at (707) 646-4644.

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